Thethi et al. J Diabetes Complications. 2010 Mar-Apr;24(2):73-8.
Changing Lines Regularly
Purpose & design:
A randomised crossover trial with 20 patients with Type 1 diabetes to investigate the lack of adherence to the recommended change in insulin pump infusion line use beyond 48h.
From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl, fasting glucose from 120.3 to 154.5 mg/dl, postprandial glucose from 114.6 to 172.1 mg/dl, and the daily maximum glucose from 207.7 to 242.8 dl. Time period that the glucose was N180 mg/dl increased from 14.5% to 38.3% (Pb.05). Loss of control occurred despite increase in total daily insulin dose from 48.5±11.8 to 55.3±17.9 U.
A prospective observational study of 3,642 patients to determine the relation between exposure to glycaemia over time and the risk of macrovascular or microvascular complications in patients with Type 2 diabetes.
The incidence of clinical complications was significantly associated with glycaemia. Each 1% reduction in updated mean HbA1c was associated with reductions in risk of 21% for any end point related to diabetes, 21% for deaths related to diabetes, 14% for myocardial infarction, and 37% for microvascular complications.
An observational follow up of DCCT study (1,394 patients randomised control trial assigned to either current conventional therapy or intensive management via pump or multiple daily injections) to compare cardiovascular complications.
Intensive cohort reduced adjusted mean risk for developing the following: